LTD Claims Analyst I

2 weeks ago

Philadelphia, Pennsylvania, United States Reliance Standard Full time
Position Overview

As a vital member of our team, you will be responsible for evaluating and processing claims related to Long-Term Disability (LTD), Voluntary Disability, and Waiver of Premium. Your primary objective will be to ensure accurate and fair claim determinations by thoroughly reviewing all relevant information and adhering to the specific terms of the applicable policy.

Key Responsibilities

  • Conduct comprehensive reviews and investigations of disability claims through effective communication with various stakeholders, including claimants, employers, and medical professionals, to gather essential information.
  • Make informed adjudication decisions in line with company policies, industry standards, and regulatory requirements, while meeting productivity and quality benchmarks.
  • Utilize medical and risk assessment resources appropriately, ensuring timely transfers of claims to the correct risk level.
  • Perform detailed investigations for pre-existing conditions or contestable claims when necessary.
  • Calculate benefit payments accurately, considering various factors such as partial disability and integration with other income sources.
  • Maintain accurate online claim records and physical files as required.
  • Deliver exceptional customer service that is respectful, prompt, and precise, even in a fast-paced environment.
Claims Analysis and Adjudication

  • Investigate straightforward claims thoroughly and provide recommendations to senior examiners or management for final review and approval.
Case Management

  • Manage a caseload of 60-80 straightforward claims efficiently.
  • Collaborate with supervisors or senior examiners to enhance desk management skills and prioritize tasks to meet all claims commitments within expected timelines.
Qualifications

  • High School Diploma or GED is required; an Associate's degree in Business, Finance, Social Work, or Human Resources is preferred.
  • Previous experience in decision-making and information analysis is essential, with a preference for candidates with a background in claims processing or insurance contracts.
  • Basic understanding of claims administration, operations, and relevant laws and regulations.
  • Strong organizational and prioritization skills.
  • Experience in environments requiring confidentiality and protection of sensitive information.
  • Proficient mathematical and calculation abilities.
Physical Requirements

Responsibilities may involve prolonged periods of sitting, frequent standing, and walking distances up to one mile. Tasks may include bending, crouching, kneeling, reaching, and occasionally lifting up to 25 lbs. Visual acuity is necessary for preparing and analyzing data, while auditory skills are required for understanding verbal instructions and answering calls.

Core Values

We uphold values of Collaboration, Compassion, Empowerment, Integrity, and Fun in our workplace culture.

What We Offer

At Reliance Standard, we are committed to fostering a diverse and inclusive environment. We provide a competitive compensation package along with a comprehensive benefits program designed to support the financial, physical, and mental well-being of our team members.

Our Benefits Include:
  • Annual performance bonuses for all employees.
  • Generous 401(k) matching contributions.
  • Choice of three medical plans with prescription coverage tailored to individual needs.
  • Multiple dental and vision coverage options.
  • Company-sponsored Life & Disability Insurance for financial security.
  • Family-friendly benefits, including Paid Parental Leave and Adoption Assistance.
  • Flexible hybrid work arrangements for eligible positions.
  • Tuition Reimbursement and Continuing Professional Education opportunities.
  • Paid Time Off, volunteer days, and community engagement initiatives.
  • Opportunities to connect with colleagues through Employee Resource Groups and Diversity, Equity & Inclusion Councils.
EEO Statement

Reliance Standard is an equal opportunity employer, making employment decisions without regard to race, color, religion, sex, national origin, age, disability, or any other protected characteristic.

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